1. You are providing care for an 82-year-old man whose signs and symptoms of
Parkinson disease have become more severe over the past several months. The
... [Show More] man
tells you that he can no longer do as many things for himself as he used to be able to
do. What factor should you recognize as impacting your patients’ life most significantly?
A) Neurologic deficits
B) Loss of independence
C) Age-related changes
D) Tremors and decreased mobility - Ans: B
Feedback:
This patient’s statement places a priority on his loss of independence. This is
undoubtedly a result of the neurologic changes associated with his disease, but this is
not the focus of his statement. This is a disease process, not an age-related
physiological change.
2. A gerontologic nurse practitioner provides primary care for a large number of older
adults who are living with various forms of cardiovascular disease. This nurse is well
aware that heart disease is the leading cause of death in the aged. What is an agerelated physiological change that contributes to this trend?
A) Heart muscle and arteries lose their elasticity.
B) Systolic blood pressure decreases.
C) Resting heart rate decreases with age.
D) Atrial-septal defects develop with age. - Ans: A
Feedback:
The leading cause of death for patients over the age of 65 years is cardiovascular
disease. With age, heart muscle and arteries lose their elasticity, resulting in a reduced
stroke volume. As a person ages, systolic blood pressure does not decrease, resting
heart rate does not decrease, and the aged are not less likely to adopt a healthy
lifestyle.
3. An occupational health nurse overhears an employee talking to his manager about a
65-year-old coworker. What phenomenon would the nurse identify when hearing the
employee state, He should just retire and make way for some new blood.?
A) Intolerance
B) Ageism
C) Dependence
D) Nonspecific prejudice - Ans: B
Feedback:
Ageism refers to prejudice against the aged. Intolerance is implied by the employees’
statement, but the intolerance is aimed at the coworker’s age. The employees’
statement does not raise concern about dependence. The prejudice exhibited in the
statement is very specific.4. The nurse is caring for a 65-year-old patient who has previously been diagnosed with
hypertension. Which of the following blood pressure readings represents the threshold
between high-normal blood pressure and hypertension?
A) 140/90 mm Hg
B) 145/95 mm Hg
C) 150/100 mm Hg
D) 160/100 mm Hg - Ans: A
Feedback:
Hypertension is the diagnosis given when the blood pressure is greater than 140/90 mm
Hg. This makes the other options incorrect.
5. You are the nurse caring for an 85-year-old patient who has been hospitalized for a
fractured radius. The patient’s daughter has accompanied the patient to the hospital and
asks you what her father can do for his very dry skin, which has become susceptible to
cracking and shearing. What would be your best response?
A) He should likely take showers rather than baths, if possible.
B) Make sure that he applies sunscreen each morning.
C) Dry skin is an age-related change that is largely inevitable.
D) Try to help your father increase his intake of dairy products. - Ans: A
Feedback:
Showers are less drying than hot tub baths. Sun exposure should indeed be limited, but
daily application of sunscreen is not necessary for many patients. Dry skin is an agerelated change, but this does not mean that no appropriate interventions exist to
address it. Dairy intake is unrelated.
6. An elderly patient has come in to the clinic for her twice-yearly physical. The patient
tells the nurse that she is generally enjoying good health, but that she has been having
occasional episodes of constipation over the past 6 months. What intervention should
the nurse first suggest?
A) Reduce the amount of stress she currently experiences.
B) Increase carbohydrate intake and reduce protein intake.
C) Take herbal laxatives, such as senna, each night at bedtime.
D) Increase daily intake of water. - Ans: D
Feedback:
Constipation is a common problem in older adults and increasing fluid intake is an
appropriate early intervention. This should likely be attempted prior to recommending
senna or other laxatives. Stress reduction is unlikely to wholly resolve the problem and
there is no need to increase carbohydrate intake and reduce protein intake.
7. An 84-year-old patient has returned from the post-anesthetic care unit (PACU)
following hip arthroplasty. The patient is oriented to name only. The patients family is
very upset because, before having surgery, the patient had no cognitive deficits. The
patient is subsequently diagnosed with postoperative delirium. What should the nurse
explain to the patients family?
A) This problem is self-limiting and there is nothing to worry about.B) Delirium involves a progressive decline in memory loss and overall cognitive
function.
C) Delirium of this type is treatable and her cognition will return to previous levels.
D) This problem can be resolved by administering antidotes to the anesthetic that was
used in surgery. - Ans: C
Feedback:
Surgery is a common cause of delirium in older adults. Delirium differs from other types
of dementia in that delirium begins with confusion and progresses to disorientation. It
has symptoms that are reversible with treatment, and, with treatment, is short term in
nature. It is patronizing and inaccurate to reassure the family that there is nothing to
worry about. The problem is not treated by the administration of antidotes to anesthetic.
8. The nurse is providing patient teaching to a patient with early stage Alzheimers
disease (AD) and her family. The patient has been prescribed donepezil hydrochloride
(Aricept). What should the nurse explain to the patient and family about this drug?
A) It slows the progression of AD.
B) It cures AD in a small minority of patients.
C) It removes the patients insight that he or she has AD.
D) It limits the physical effects of AD and other dementias. - Ans: A
Feedback:
There is no cure for AD, but several medications have been introduced to slow the
progression of the disease, including donepezil hydrochloride (Aricept). These
medications do not remove the patients insight or address physical symptoms of AD.
9. A nurse is caring for an 86-year-old female patient who has become increasingly frail
and unsteady on her feet. During the assessment, the patient indicates that she has
fallen three times in the month, though she has not yet suffered an injury. The nurse
should take action in the knowledge that this patient is at a high risk for what health
problem?
A) A hip fracture
B) A femoral fracture
C) Pelvic dysplasia
D) Tearing of a meniscus or bursa - Ans: A
Feedback:
The most common fracture resulting from a fall is a fractured hip resulting from
osteoporosis and the condition or situation that produced the fall. The other listed
injuries are possible, but less likely than a hip fracture.
10. The case manager is working with an 84-year-old patient newly admitted to a
rehabilitation facility.
When developing a care plan for this older adult, which factors should the nurse identify
as positive attributes that benefit coping in this age group? Select all that apply.
A) Decreased risk taking
B) Effective adaptation skills
C) Avoiding participation in untested roles
D) Increased life experienceE) Resiliency during change - Ans: B, D, E
Feedback:
Because changes in life patterns are inevitable over a lifetime, older people need
resiliency and coping skills when confronting stresses and change. It is beneficial if
older adults continue to participate in risk taking and participation in new, untested roles. [Show Less]